Individual
MRS. DOMINIQUE MARTIN-MITCHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
17415 17TH AVE E, SPANAWAY, WA 98387-5522
(253) 536-3274
Mailing address
17415 17TH AVE E, SPANAWAY, WA 98387-5522
(253) 536-3274
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
00003270
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00003270
INDUSTRIAL REHAB
WA
Enumeration date
07/30/2007
Last updated
07/30/2007
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